Begining in the 2000s medical educators discussed how to best teach and assess important, practical, "real life" physician competencies, e.g., taking a history and performing a physical examination. Drawing on medical educators' and physicians' published proposals and research,[1] professional medical associations and leading medical educators, led by the Association of American Medical Colleges (AAMC), developed core entrustable professional activities (EPAs), which are defined as follows:
Entrustable professional activities (EPAs) are a novel method of operationalizing competencies and milestones in the context of actual clinical work. By definition, an EPA reflects relevant competencies and milestones; requires skills, knowledge, and attitudes; addresses a professional task with a recognizable output; and can be observed and judged by an expert. EPAs naturally focus on holistic performance of actual physician tasks.[2]
The word "entrustable" refers to medical competencies (abilities, tasks) for which trainees gradually assume more independent responsibility. In medical teaching settings, supervisors decide when and for what tasks they can trust trainees (e.g., medical students, residents, physican assistants) to assume clinical responsibilities.
List of core entrustable professional activities for entering residency[3] edit
- Gather a history and perform a physical
- Prioritize a differential diagnosis following a clinical encounter
- Recommend and interpret common diagnostic and screening tests
- Enter and discuss orders/prescriptions
- Document a clinical encounter in the patient record
- Provide an oral presentation of a clinical encounter
- Form clinical questions and retrieve evidence to advance patient care
- Give or receive a patient handover to transition care responsibility
- Collaborate as a member of an interprofessional team
- Recognize a patient requiring urgent or emergent care, and initiate evaluation and management
- Obtain informed consent for tests and/or procedures
- Perform general procedures of a physician (IV line insertion, Phlebotomy, BVM ventilation, CPR)
- Identify system failures and contribute to a culture of safety and improvement
References edit
- ^ ten Cate, T. J. (Olle); Snell, Linda; Carraccio, Carol (2010). "Medical competence: the interplay between individual ability and the health care environment". Medical Teacher. 32 (8): 669–675. doi:10.3109/0142159X.2010.500897. ISSN 1466-187X. PMID 20662579.
- ^ Hauer, Karen E.; Soni, Krishan; Cornett, Patricia; Kohlwes, Jeff; Hollander, Harry; Ranji, Sumant R.; ten Cate, Olle; Widera, Eric; Calton, Brook (2013-08-01). "Developing Entrustable Professional Activities as the Basis for Assessment of Competence in an Internal Medicine Residency: A Feasibility Study". Journal of General Internal Medicine. 28 (8): 1110–1114. doi:10.1007/s11606-013-2372-x. ISSN 0884-8734.
- ^ Obeso V, Brown D, Aiyer M, Barron B, Bull J, Carter T, Emery M, Gillespie C, Hormann M, Hyderi A, Lupi C, Schwartz M, Uthman M, Vasilevskis EE, Yingling S, Phillipi C (eds.); Core EPAs for Entering Residency Pilot Program. Toolkits for the 13 Core Entrustable Professional Activities for Entering Residency. Washington, DC: Association of American Medical Colleges; 2017.
External links edit
- The Core Entrustable Professional Activities (EPAs) for Entering Residency - Association of American Medical Colleges hub page with links to various resources and publications.
- Core Entrustable Professional Activities (EPAs) for Entering Residency: Curriculum Developer's Guide - See in particular Appendix B: Bulleted List of Expected Behaviors for Pre-entrustable and Entrustable Learners (pp. 86–99).